Published Online
on April 3, 2003

A more recent version of this article appeared on May 1, 2003

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Submitted on November 19, 2002
Accepted on November 28, 2002

Seasonal Variation in Stroke in the Hunter Region, Australia. A 5-Year Hospital-Based Study, 1995-2000

Yang Wang MD, PhD^*; Christopher R. Levi MBBS, FRACP; John R. Attia MD, PhD; Catherine A. D'Este PhD; Neil Spratt BMed, BMedSci; and Janet Fisher BMaths

From John Hunter Hospital/Hunter Medical Research Institute, New Lambton Heights, Australia (Y.W., C.R.L., N.S.); Centre for Clinical Epidemiology and Biostatistics, Royal Newcastle Hospital, Newcastle, New South Wales (J.R.A., C.A.D.); and Heart and Stroke Register, Centre for Clinical Epidemiology and Biostatics, Royal Newcastle Hospital, Newcastle, New South Wales (J.F.).

^* To whom correspondence should be addressed. E-mail: Yang.Wang{at}hunter.health.nsw.gov.au.

Background and Purpose--Seasonal variation in stroke has long been recognized. To date, there are minimal published data on seasonal variations in rates of stroke and subsequent case fatality in the Southern Hemisphere. The aim of this study was to examine stroke seasonality through the use of data from a hospital-based stroke register in the Hunter Region of New South Wales, Australia.

Methods--From July 1, 1995, to June 30, 2000, 3803 stroke events were registered in residents of the Hunter Region, New South Wales, Australia. We analyzed the trend of seasonal and monthly stroke attack rates and case-fatality rates using Poisson regressions with age and sex as covariates.

Results--Stroke attack rates were highest in the winter and lowest in the summer. From February (summer) to July (winter), there was a significant trend in increasing stroke attack rates (rate ratio, 1.07; 95% confidence interval, 1.05 to 1.10; P<0.001). This increase was seen mainly in those 65 years of age. Case-fatality rates showed similar trends with a 1- to 2-month lag compared with attack rates.

Conclusions--There is an increase in stroke attack rates and case-fatality rate from summer to winter in the Hunter Region, Australia. These trends are similar to those found in the Northern Hemisphere.

Key words: case fatality rate • incidence • seasons • stroke

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